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Impact of Communications and Hearing Impairment

In this episode of Kessler Foundation’s podcast, Pamela Tamulevicius, MSR, CCC-SLP, of Kessler Institute for Rehabilitation presents “Disability Disparities: The Impact of Communication and Hearing Impairments.”


This is part five of an eight part series. Listen to the series as it's posted. 

Listen to the podcast, view the transcript and download this episode and others for free on Apple PodcastsSoundCloudPodbeanor where ever you get your podcasts.

Below is an excerpt from the lecture.

Today I'm going to discuss the impact of communication and hearing impairments on a person's access to quality care. I'll list some of the long-term impacts of disability disparity and apply some interprofessional strategies to address disparities due to communication and/or hearing impairments. So how I came up with this lecture topic idea and why we brought it to this conference was recently ASHA Leader, which is a magazine for speech-language pathologists, had published two articles. One on hearing disparities and one on communication disparities. And really, highlighting the impact that those two disorders can have on the long-term effects of our patients and what does that look like to all of us, because we're all responsible for ensuring that our patients are able to get the care that they require.

And ASHA's vision statement is making effective communication, a human right, accessible and achievable for all. So part of the role of speech-language pathologists and audiologists is to make sure that we are looking at environments and educating our professional partners and maintain this right for all of our patients. You'll hear this as well as we go through, trying to make it more personal because our patients are persons and there's more to that than just being able to make a health care decision.

Stroke Overview

So to start, the burden of stroke. So someone in the US has a stroke every 40 seconds. Someone dies of a stroke every four minutes. 7.2 million Americans over 20 years of age have had a stroke. 3.4 million US adults over the age of 18 will have had a stroke by 2030. Huge numbers. And the problems? High cost. Challenges with communication across systems of care. And then this last one. Prevention, treatment, and recovery. Functional outcomes for stroke survivors. And as you heard in the lectures earlier today, really what is happening internally? What's happening in the acute care hospitals, in the rehabs, in the nursing homes, and then back when patients go home that's keeping them home? And there's a real challenge there with keeping patients at home. And so today we'll talk about the impact that hearing and communication have on that, keeping patients at home.

Impact of Hearing & Communication 
All right. Hearing loss. 15% of Americans aged 18 and older present with some form of hearing loss. Those with a hearing loss, and this is in the research, are more likely to experience arthritis, cancer, stroke, cardiovascular disease, diabetes, emphysema, high blood pressure, falls, mental health issues, and difficulty with cognitive functioning and activities of daily living. Those with a hearing loss are more likely to be hospitalized and readmitted within 30 days for that same condition. Why? They report poor communication and satisfaction during medical care encounters and have higher health care costs.

An individual with a hearing loss will cost the health system $22,000 more over 10 years because of the associated medical comorbidities. So hearing loss is a chronic condition. A chronic condition that is expensive to treat. Does anybody know what the average costs of a hearing aid is? Between one and seven thousand dollars. And that's for one. We have two ears. And think localization-wise, being able to really take in that information. 15% of patients over the age of 50 that require hearing aids wear a hearing aid. Unbelievable. The access to hearing aids. Being able to know that you have a hearing loss and having that diagnosed.

Imagine hearing only part of your medical team's care instructions or description of a procedure and then being asked to make a decision about your care. Who here has, just in general, had a conversation with a friend and your friend says something and you didn't quite get it but you say yes anyway, right? Why not? They're not there to harm you because you trust them, right? But you don't really know. So what are we doing as providers to make sure or to ensure that our patients have access to this? Interventional audiology.

So at the University Pittsburgh Medical Center, they had identified that many patients that were coming in with an undiagnosed hearing loss were coming in and having difficulty hearing. So what did they do? They purchased headset amplifiers. They range about $70 or so, give or take, depending on the quality. And they are free access. So every patient that requires one gets one. And at first, some of the providers were concerned. They didn't know how this would impact their conversations. What it would look like.